This disclosure relates to surgical instruments, and in particular to electrosurgical instruments utilized in total laparoscopic hysterectomy (TLH) procedures.
Electrosurgical instruments used to resect a patient's cervix from the vagina are known. Such instruments generally carry out a number of functions: positioning of the uterus for resection, maintaining pneumoperitoneum during tissue resection, aiding in physician visibility during resection, and incision and resection of a patient's cervix from the vagina. It is known to provide a colpotomy device having an electrosurgical element and a uterine manipulator to aid in incising and positioning the uterus for resection.
In general, the incision and resection are performed by a single electrosurgical instrument. This is typically introduced laparoscopically into the abdomen through a trocar or other similar device.
It is also known for the incision and resection to be performed by two electrosurgical instruments. Although one electrosurgical instrument may be introduced vaginally, at least one other electrosurgical instrument is typically introduced laparoscopically into the abdomen through a trocar or other similar device.
Instead of an electrosurgical instrument, mechanical cutting instruments such as scissors are sometimes used to form the incision.
Some known electrosurgical instruments make use of a colpotomy cup in order to position and manipulate the uterus for resection. These can take many forms, but generally have a leading edge which fits at or near the cervico-vaginal junction. Colpotomy cups sometimes also carry a monopolar electrosurgical cutting instrument, either attached to the cup, or attached to another apparatus located near the patient's uterus.
Monopolar devices exist for performing the incision to sever the cervix from the vagina. A first or “active” electrode performs the cutting in these configurations, with a second or “return” electrode placed elsewhere on the body.
In addition to resection of the patient's cervix from the vagina, the uterus, once resected, must be removed from the patient's pelvis. In TLH procedures, the uterus is often removed vaginally.